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The agencies cited the slow delivery and implementation of the upgraded 2014 Edition software as the reason for the delay.

“Through letters to CMS, public forums, listening sessions and public comment at CMS meetings, many provider associations have expressed concern that, although 2014 Edition (technology) may be available for adoption, there is a backlog of many months for the updated version to be installed and implemented so that providers can successfully attest for 2014,” the rule writers said. “We also understand that the delay in availability may limit a provider's ability to fully implement 2014 Edition (technology) across the facility.”

ONC head Karen DeSalvo, M.D., said the modified timeline “will give new options to those who, through no fault of their own, have been unable to get the new 2014 Edition technology, including those at high risk, such as smaller providers and rural hospitals.”

Although providers have been pressing hard for leeway, the change leaves them scrambling.

That's particularly true for leaders of hospitals planning to move up to Stage 2. Their payment year under the program began Oct. 1, 2013, and because the current rule allows them to begin their 90-day attestation periods for Stage 2 only on the first day of the fiscal quarters. That leaves hospitals one period to react to the rule change. And their ranks include virtually all of the hundreds of hospitals scheduled to meet Stage 2 requirements for the first time this year.

“I've always respected the people at ONC for actually trying to work with us,” said Richard Schreiber, M.D., chief medical informatics officer at Holy Spirit Health System in Camp Hill, Pa.

But Schreiber, whose hospital qualified for meaningful use payments in 2012 and 2013 and is scheduled to move up to Stage 2 this payment year, wonders if the proposed rule is “too little too late,” given the protracted rulemaking process. The comment period on the proposed rule is 60 days. “If it's going to be four to six month to final regs, three months brings us into the next quarter and I've already had to make my decision.”

Modern Healthcare is a sister publication to Crain’s Detroit Business.